John Michael Porter, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT001822 Issued in GA

Practice address

360 Northside Dr E
Statesboro, GA 30458-4839

Phone

(912) 764-9147

Fax

(912) 764-7219

NPI assigned

Apr 5, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Myeyedr Optometry of Georgia, LLC

  • Optometrist
  • Statesboro, GA
  • NPI 1083675136
  Medicare reassignment NPD
• Myeyedr Optometry of Georgia, LLC

  • Optometrist
  • Savannah, GA
  • NPI 1164549366
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1386606374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1009",
            "address_2": "360 NORTHSIDE DR. E",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304591009",
            "telephone_number": "912-764-9147",
            "fax_number": "912-764-7219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 NORTHSIDE DR E",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584839",
            "telephone_number": "912-764-9147",
            "fax_number": "912-764-7219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pineland CSB
• Pineland Mental Health,Mental Retardation & Substance Abuse Services
• George Peter Piros, M.D.
• Leslie A Pittman, MD
• Linda Charanne Pittman
• Shani Porter
• Scott T. Pottratz, M.D.
• Madison Powell
• Matthew Daniel Powellson, M.D.
• Premier Dental Wellness LLC

• Optometrist in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.